Prophylactic antibiotics in endoscopic sinus surgery: A short follow-up study

Background: The study was designed to assess the usefulness of postoperative antibiotics in patients undergoing endoscopic sinus surgery (ESS). Methods: The effects of antibiotics in the postoperative period of ESS patients were evaluated in a prospective, randomized, double-blind, placebo-controlled study. Fifty patients were treated with amoxicillin/clavulanate for 2 weeks after ESS, while the other half received placebo. Preoperatively, the symptom, endoscopic, and CT scores were recorded. In the postoperative period, symptom and endoscopic scores were recorded on the 5th, 12th, 21st, and 30th days. In estimating the length of the blood crust formation episode, a Kaplan-Meier plot was used. Results: Seventy-five patients completed the study: forty in the antibiotic-treated group and thirty-five in the placebo group. On the 5th day, nasal obstruction and drainage were significantly better in the antibiotic-treated group. In addition, a statistically significant difference in the endoscopic scores was noted between the treatment and placebo groups on days 5 and 12. Conclusion: The use of an antibiotic (amoxicillin/clavulanate) in the postoperative period is able to improve the outcome in the early blood crust healing phase: nasal obstruction and drainage are reduced and the endoscopic score objectively showed a faster recovery. (Am J Rhinol Allergy 24, 306-309, 2010; doi: 10.2500/ajra.2010.24.3475)